The Efficacy of Neoadjuvant Atezolizumab Treatment in Patients With Advanced Urothelial Bladder Cancer
Status:
Not yet recruiting
Trial end date:
2022-05-31
Target enrollment:
Participant gender:
Summary
Recently, promising evidences that blocking PD-1 and PD-L1 is an efficacious way to treat
advanced stage bladder cancer patients. Atezolimumab is the first PD-L1 inhibitor approved by
US FDA for advanced UBC in June 2014. These novel agents will become the standard therapy for
unhopeful UBC patients who fail to respond to cisplatin-based chemotherapy and finally, the
first-line treatment would be changed from cisplatin-based chemotherapy to immune check point
inhibitors for advanced UBC, particularly neoadjuvant setting.
Additionally, along with enormous analysis of genomic landscape of bladder cancer, a
consensus was reached regarding the existence of a group of Basal-Squamous-like tumors -
designated BASQ - characterized the high expression of KRT5/6 and KRT14 and low/undetectable
expression of FOXA1 and GATA3. This novel molecular classification can improve the
identification of optimal patient population for different treatment modalities.
Specifically, luminal type and basal type may have different treatment response and prognosis
after initial definitive treatment, such as neoadjuvant treatments.
However, there is no evidence for this topic, particularly the clinical efficacy of
neoadjuvant PD-L1 inhibitors according to the BASQ classification in patients with advanced
urothelial bladder cancer.